Is it possible to find a reason behind Challenging Behaviours?
21st January 2020
It is a well-documented phenomenon that an individuals’ behaviour can become “challenging” after sustaining a traumatic brain injury (TBI) regardless of the cause. Although these behaviours cannot always be helped and are not intended to upset or offend others, it is important to have appropriate and effective support.
All behaviour is a form of communication. Therefore, we must assume and accept that just because the behaviour is challenging, it does have a function for that individual. It may not be an obvious function as it may be driven either from the conscious or the unconscious but could be essential and so needs to be understood.
An easy way to think about this is looking at it from the perspective of a child. It is well-known that children start developing challenging behaviours when they reach two years old, hence their renowned nickname “terrible twos”. However, these behaviours are due to them knowing what they want (i.e. if they are hungry, thirsty, tired or want to do something), but are yet to learn the language or social signals to communicate this. The only thing they are capable of being able to do is enact a behavioural response (i.e. crying or having a tantrum).
So, how does this link this with an individual who has suffered a brain injury?
It is possible that after brain injury, memory is affected which suggests an individual may have difficulty finding the right words to express their thoughts. Therefore, as they cannot verbally communicate exactly what they want at that given time, it could lead to frustration and therefore presenting itself as a challenging behaviour (i.e. becoming angry or aggressive). There are many other examples that also fit this pattern; an individual may have verbal difficulties, concentration difficulties, sequencing difficulties or other cognitive difficulties that can elicit an inappropriate behavioural response.
Here are a few basic examples of WHY challenging behaviours may be presenting:
- Social attention
Although many people use the phrase “oh they’re just doing it for attention” this may actually be correct and when communication is limited, this can be a viable method of attracting someone’s attention. Everyone needs attention, so it is important to try and underpin what attention they require.
- Escape
To look at the opposing perspective, some people express this behaviour as a means of being left alone or to detract attention. For example, an individual may dislike being in large groups, so they shout loudly resulting in them being removed from the situation. This is then a learned, successful behavioural response which would be repeated in similar situations.
- To gain reward
This could mean the behaviour is a way of getting things they need such as food, water or specific objects. Again, it is not irrational to want these things, but it is when challenging behaviours become a learned response that it becomes problematic.
- Sensory
This is particularly relevant with those with learning difficulties and very limited verbal communication techniques, as they enjoy the feeling of the behaviour presented. For example, this could be humming or rocking back and forth.
Considering all of the above, it is incredibly important to remember that we do not all view or interpret behaviour in the same way. Our interpretation of others’ behaviours can vary person to person and is completely reliant upon on our previous experiences. Therefore, it is essential to work together to interpret the challenging behaviour from the perspective of the individual. You can follow this three-step technique with the individual to support their challenging behaviours:
- Identify the undesirable behaviour with your client
- Recognise what is this purpose of this message
- Work together to find out what can be done to change these behaviours
For more information on CHALLENGING BEHAVIOURS, particularly with those who have suffered a brain injury, have a look at our specialised TRAINING SESSIONS that is designed to go into more depth of how to cope and support individuals with their challenging behaviours designed for case managers, psychologists, OT’s or anyone who is working with or caring for someone with challenging behaviours.
Please email training@psychologychartered.co.uk to book yourself a place or have a look at our website https://psychologychartered.co.uk/training/
References
https://www.braininjuryhub.co.uk/information-library/behaviour
https://www.challengingbehaviour.org.uk/understanding-behaviour/finding-the-reasons.html